Worldwide trends in mortality for hypertensive heart disease from 1990 to 2019 with projection to 2034: data from the Global Burden of Disease 2019 study.

AIMS: This study aims to analyse the worldwide trends in hypertensive heart disease (HHD) mortality and associations with age, period, and birth cohort and predict the future burden of HHD deaths. METHODS AND RESULTS: Mortality estimates were obtained from Global Burden of Disease 2019 study. We used age-period-cohort (APC) model to examine the age, period, and cohort effects on HHD mortality between 1990 and 2019. Bayesian APC model was utilized to predict HHD deaths to 2034. The global HHD deaths were 1.16 million in 2019 and were projected to increase to 1.57 million in 2034, with the largest increment in low- and middle-income countries (LMICs). Between 1990 and 2019, middle/high-middle socio-demographic index (SDI) countries had the largest mortality reductions (annual percentage change = -2.06%), whereas low SDI countries saw a lagging performance (annual percentage change = -1.09%). There was a prominent transition in the age distribution of deaths towards old-age population in middle/high-middle SDI countries, while the proportion of premature deaths (aged under 60 years) remained at 24% in low SDI countries in 2019. Amongst LMICs, Brazil, China, and Ethiopia showed typically improving trends both over time and in recent birth cohorts, whereas 63 countries including Indonesia, the Philippines, and Pakistan had unfavourable or worsening risks for recent periods and birth cohorts. CONCLUSION: The HHD death burden in 2019 is vast and is expected to increase rapidly in the next decade, particularly for LMICs. Limited progress in HHD management together with high premature mortality would exact huge human and medical costs in low SDI countries. The examples from Brazil, China, and Ethiopia suggest that efficient health systems with action on improving hypertension care can reduce HHD mortality effectively in LMICs.

This study provides the first comprehensive analysis of the age, period, and cohort trends in mortality for hypertensive heart disease (HHD) across 204 countries and territories from 1990 to 2019, with projection to 2034. The death burden of HHD is substantial and growing rapidly in most of the world, particularly in low- and middle-income countries (LMICs). Wide disparities exist within LMICs in HHD management, with most low socio-demographic index countries showing little progress in reducing HHD mortality. The examples from Brazil, China, and Ethiopia suggest that prevention policies for HHD can reduce risks for younger birth cohorts and shift the risks for all age groups over time.

Microneedling Monotherapy for Acne Scar: Systematic Review and Meta-Analysis of Randomized Controlled Trials.

INTRODUCTION: Acne scarring, formed by the deposition of collagen following inflammatory acne, not only represents a cosmetic problem but also poses a psychological health risk to patients. As microneedling has become a common treatment for acne scarring, an increasing number of studies have compared the efficacy and safety of microneedling. In this study, we conducted a meta-analysis of randomized controlled trials (RCTs) comparing microneedling with other treatments. METHOD: Three databases, namely Embase, PubMED, and Cochrane library, were searched until June 20, 2021, for RCTs only. Studies using microneedling in both treatments were excluded. RESULTS: Twelve studies, totaling 414 participants, were included in our meta-analysis. For objective scar improvement, the pooled estimate analysis of the first group, treated with microneedling without radiofrequency, yielded a mean difference of 0.42 (95% CI-0.12-0.73%) with a significant difference at the 5% significance level. The second group, treated with fractional radiofrequency microneedling, exhibited no significance at the 5% significance level. Regarding subjective satisfaction, most results exhibited no significant difference between microneedling and other treatments. Although no case of secondary scarring or infection was reported in our study, the pooled result of postinflammatory hyperpigmentation was significant at the 5% significance level and preferred microneedling treatment. CONCLUSION: Microneedling without radiofrequency achieved superior results in terms of scar improvement. No form of microneedling caused postinflammatory hyperpigmentation-an advantage in acne scar treatment. Thus, microneedling is a favorable choice for the treatment of acne scarring. LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Accumulation and Depuration of Cd and its Effect on the Expressions of Metallothionein and Apoptotic Genes in Litopenaeus vannamei.

We investigated cadmium (Cd) accumulation in muscles, gills and hepatopancreas of Litopenaeus vannamei following 48 h exposure to 5.25 mg/L, and depuration of Cd in these tissues on 1, 5 and 15 d post exposure. We also detected the expressions of metallothionein (MT), caspase-3 and p53 in hepatopancreas of shrimp exposed to 0, 5.25 and 10.5 mg/L Cd (the 24 h median lethal concentration, 24 h LC50) at 0, 3, 12, 24 and 48 h. Cd accumulated with high concentration in hepatopancreas, and low concentration in muscles. Cd depurated fast in hepatopancreas and gills. MT expression increased in a time-dependent manner after Cd exposure. The p53 and caspase-3 increased at 12 and 24 h in 10.5 mg/L group. In conclusion, the accumulation and depuration of Cd in three tissues were tissues-specific. The changes of the expressions of MT, p53 and caspase-3, were stress response of L. vannamei under Cd exposure.

Pulmonary thromboembolism after distal ulna and radius fractures surgery: A case report and a literature review.

BACKGROUND: Pulmonary thromboembolism (PTE) is a serious postoperative complication that can occur after a fracture. Generally, PTE is caused by the falling off of lower extremity deep vein thrombosis (LEDVT) after lower limb fracture surgery. LEDVT and PTE after upper extremity fracture surgery are very rare. PTE is one of the most common clinical causes of sudden death. Venous thromboembolism includes PTE and DVT. We experienced one case of LEDVT and PTE after distal ulna and radius fracture surgery. The purpose of our report is to raise awareness for orthopedic surgeons that PTE can occur after distal ulna and radius fracture surgery, and patients with high risk factors should be considered for prevention and treatment of thrombosis in a timely manner. CASE SUMMARY: We report a 51-year-old Chinese male who had severe fractures of the left distal ulna, radius and little finger after a motorcycle accident. The patient underwent external fixation, open reduction and internal fixation. On the third post-operative day, computed tomographic pulmonary angiography showed PTE. Doppler ultrasonography showed thrombus formation in the bilateral posterior tibial veins. After a period of anticoagulation therapy, on the 25th d after the PTE, computed tomographic pulmonary angiography showed that thrombus in both sides of the pulmonary artery disappeared. Furthermore, about 4 mo after the PTE, thrombosis in the deep veins of the lower limbs disappeared. About 1 year after the surgery, X-rays showed good fracture healing, and the function of the wrist joint recovered well. CONCLUSION: Though rare, PTE can occur after distal ulna and radius fracture surgery and patients with high risk factors should be considered for prevention and treatment of thrombosis in a timely manner.

Impacts of anthropogenic disturbances on microbial community of coastal waters in Shenzhen, South China.

During the urbanization, human activities have brought great changes to marine biodiversity and microbial communities of coastal water. Shenzhen is a coastal city that has developed rapidly over the past four decades, but the microbial communities and metabolic potential in offshore water are still not well characterized. Here, 16S rRNA gene V4-V5 sequencing was conducted to determine the microbial components from coastal waters in twenty selected areas of Shenzhen. The results showed a significant difference on the microbial composition between the western and eastern waters. Samples from western coast had more abundant Burkholderiaceae, Sporichthyaceae, Aeromonadaceae, and Methylophilaceae compared to eastern coast, and at the genus level, Candidatus Aquiluna, Aeromonas, Arcobacter, Ottowia and Acidibacter were significantly higher in western waters. There was also a notable difference within the western sample group, suggesting the taxa-compositional heterogeneity. Moreover, analysis of environmental factors and water quality revealed that salinity, pH and dissolved oxygen were relatively decreased in western samples, while total nitrogen, total phosphorus, chemical oxygen demand, and harmful marine vibrio were significantly increased compared to eastern waters. The results suggest the coastal waters pollution is more serious in western Shenzhen than eastern Shenzhen and the microbial communities are altered, which can be associated with anthropogenic disturbances.

Effectiveness of corticosteroids versus adrenocorticotropic hormone for infantile spasms: a systematic review and meta-analysis.

OBJECTIVE: To compare the therapeutic effectiveness of oral corticosteroids with that of adrenocorticotrophic hormone for infantile spasms. METHODS: PubMed, Embase, Scopus, and the Cochrane library were searched to retrieve studies published before December 2018 to identify pediatric patients with a diagnosis of infantile spasms. The interventions of oral corticosteroids and adrenocorticotrophic hormone were compared. We included only randomized controlled trials that reported the cessation of spasms as treatment response. The primary outcome was clinical spasm cessation on day 13 or 14. The secondary outcomes were the resolution of hypsarrhythmia, side effects, continued spasm control, spasm relapse rate, and subsequent epilepsy rate. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, the study-level quality assessment was conducted using the Cochrane risk-of-bias tool. RESULTS: After extensive review, 39 articles were included for meticulous evaluation. Five randomized controlled trials with a total of 239 individuals were eligible for further analysis. No significant difference was detected between the corticosteroids and adrenocorticotrophic hormone in the cessation of clinical spasms (odds ratio [OR]: 0.54; 95% confidence interval [CI]: 0.16 to 1.81; P = 0.32). The subgroups of high-dose prednisolone versus adrenocorticotrophic hormone and low-dose prednisone versus adrenocorticotrophic hormone also exhibited no significant difference. Furthermore, the two subgroups did not differ in terms of hypsarrhythmia resolution, side effects, relapse rate, or subsequent epilepsy rate. INTERPRETATION: This meta-analysis suggests that high-dose prednisolone is not inferior to adrenocorticotrophic hormone and that it be considered a safe and effective alternative treatment.

Differential expression of microRNAs in hemocytes from white shrimp Litopenaeus vannamei under copper stress.

MicroRNAs (miRNAs) are small noncoding RNAs that regulate diverse cellular processes, including organismal stress response, through posttranscriptional repression of gene transcripts. They are known to have antiviral functions in aquatic crustacean species, but little is known about the role of miRNAs against environmental stress caused by Cu, a common chemical contaminant in aquatic environment. We performed small RNA sequencing to characterize the differentially expressed microRNAs in Cu exposed shrimp. A total of 4524 known miRNAs and 73 novel miRNAs were significantly (P < .05) differentially expressed after Cu exposure. The peak size of miRNAs was 22 nt. Among them, 218 miRNAs were conserved across 115 species. The validation of 12 miRNAs by stem-loop quantitative RT-PCR were found to be coherent with the expression profile of deep sequencing data as evaluated with Pearson's correlation coefficient (r = 0.707). Target genes of these differentially expressed miRNAs related to immune defense, apoptosis, and xenobiotics metabolism also showed significant changes in expression under Cu stress. The present study provides the first characterization of L. vannamei miRNAs and some target genes expression in response to Cu stress, and the findings support the hypothesis that certain miRNAs along with their target genes might be essential in the intricate adaptive response regulation networks. Our current study will provide valuable information to take an insight into molecular mechanism of L. vannamei against environmental stress.

[Treatment of intra-articular calcaneal fractures with unilateral external fixator combined with limited internal fixation].

OBJECTIVE: To study the clinical effects of the unilateral external fixator combined with limited internal fixation such as cannulated lag screws for the treatment of intra-articular calcaneal fractures. METHODS: From May 2007 to February 2012,52 patients (58 feet) with intraarticular calcaneal fractures were treated with unilateral external fixator and limited internal fixation such as lag screws. Forty-five patients (51 feet) were male,7 patients (7 feet) were female,ranging in age from 18 to 64 years,averaged 36.5 years. Time from injury to surgery was 4 to 13 (6.2 +/- 0.8) days. According to Sanders classification, there were 36 cases (40 feet) with type II fractures, 13 cases (15 feet) with type III fractures, 3 cases (3 feet) with type IV fractures. All patients were examed with X-ray and CT. Böhler angle, Gissane angle, length, width, height were measured on the radiographs, respectively. The function of the feet was assessed by the Maryland grading system. RESULTS: Fifty-one patients(57 feet) were followed up for 5 to 16 months,with an average of 7.2 months. Calcaneal Böhler angle increased from (12.65 +/- 5.32) degrees preoperatively to (30.63 +/- 4.28) degrees postoperatively. The calcaneal Gissane angle decreased from (129.87 +/- 6.25) degrees preoperatively to (122.11 +/- 4.89) degrees postoperatively. The calcaneal length increased from (64.5 +/- 7.1) mm preoperatively to (71.3 +/- 5.7) mm postoperatively. The calcaneal width decreased from (34.6 +/- 5.7) mm preoperatively to (28.2 +/- 6.1) mm postoperatively. The calcaneal height increased from (30.2 +/- 5.2) mm preoperatively to (39.3 +/- 6.4) mm postoperatively. All of the comparison between preoperative and postoperative measurements revealed statistically significant (P < 0.05). The length,width, height, Böhler angle and Gissane angle were improved significantly (P < 0.05). According to the Maryland grading system, the result was excellent in 20 feet, good in 31 feet, fair in 4 feet, pour in 2 feet,excellent and good rate was 89.5%. Three feet with wound infection or flap necrosis were healed after wound debridement and dressing exchange. CONCLUSION: The unilateral external fixation combined with limited internal fixation is a satisfactory treatment for intra-articular calcaneal fractures in short term with less damage, few complications and good functional recovery.